Worksheet III: Theoretical approach

1.
What overall intervention approach or approaches best address the targeted
area(s) of occupation and desired outcomes? (See OT Practice Framework Table 9) Consider and Explain: Create/Promote (health promotion), Establish/Restore (remediate), Maintain Modify (Compensate/adapt), Prevent

Establish restore approach because our goal is to develop and refine social interaction so that they can be successful in kindergarten.


2.
References for theoretical perspective: Identify the theoretical or conceptual model(s), perspective(s), and frame of references that guide this intervention in order to achieve targeted outcomes? Please include a reference for each theoretical perspective below:

Social Learning Theory:
Bandura, A. (1977). Social learning theory. Upper Saddle River, NJ: Prentice Hall.

Situated Learning Theory:
Lave, J. & Wegner, E. (1991). Situated Learning. Legitimate Peripheral Participation. Cambridge, United Kingdom: Cambridge University Press.

Theory of Play
Piaget J. (1962). Play, dreams, and imitation in child- hood. New York: Norton.

For each theoretical perspective, answer the following questions:

a. The nature of persons and how they learn and change? (What assumptions are made about people & how they learn/change? How might you think about your client/students’ needs from this perspective?)

Situated Learning Theory: According to Lave and Wenger (1991) a client should learn skills within real-life contexts, and have opportunities to practice the task while getting feedback from people who are experts at the task. If individuals learn skills in natural contexts, it is expected that tasks will have greater meaning for the client, leading to greater outcome achievement. Additionally, it is assumed that skills are more likely to be generalized if learned within the client’s natural context. The interventions provided in our group occur within the classroom; the actual environment that the children are expected to use their social skills on a regular basis.

Theory of Play: Piaget (1962) puts forth the idea that play is a source of creativity for children and a medium through which a child is able to assimilate new ideas presented to them by the environment and internalize them by changing their internal world to accommodate these changes. If a child engages in play experiences that are structured within the child’s environment, learning will occur as new experiences bombard the child and change their internal representation of the world.

Social Learning Theory: According to Social Learning Theory, cognitive development is dependent on social interaction. The basic premises of social learning theory are: learning occurs within a social context, reinforcement plays a role in learning but is not entirely responsible for learning, people can learn through observation, and learning can occur without a change in behavior. Therefore, learning is a function of the activity, context, and culture in which it occurs and complex mental processes begin to form as social activities internalized. For our preschool students trying to learn social skills, social learning theory says they will likely learn best by watching and interacting with others. Within the classroom setting, this means that we as leaders, along with the other teachers in the room, need to be setting good examples for the children and modeling appropriate techniques. We can also have the children try out various social interaction techniques with one another, and then reward them for appropriate behavior.

b. Evaluation? (How is occupational performance evaluated? What instruments, interviews, etc. are appropriate? Are there special assessments associated with this theoretical approach?)

The students’ social participation will be evaluated using a 20-item questionnaire, adapted from the social domains of the School Function Assessment (SFA). This form will be filled out for each student prior to our group intervention, as well as at the end of our group, to monitor/track progress and the students’ achievement of outcomes. Additionally, each week, students will be encouraged to set their own goals and identify a specific body awareness social skill they would like to work on during the session (saying excuse me, finding another route, asking permission to share space). At the end of the group, each student will be asked to evaluate their performance and identify if they met their goal. Each week, badges will be given to students if their goals were me. Finally, through skilled observation, group leaders will identify the social skills, specifically the body awareness component, utilized by the students during the group session, and document this on a checklist:


Says excuse me
Finds another route
Asks permission to share space
# of personal space intrusions
Student #1




Student #2




Student #3




Student #4




Student #5





Social Learning Theory: When using the social learning theory, occupational performance is evaluated primarily with observation. If goals are set at the beginning of the intervention, performance can also be evaluated based on the progress made towards those goals, but there are no special assessments associated with social learning theory. For our group, we will primarily be evaluating the student’s through our own observations from week-to-week, and with an observation-based questionnaire that the teacher will fill out in the first and last weeks of the group.

c. Mechanisms and techniques for intervention related to learning and change? (How is the process of change defined/described? Using this theoretical perspective, what might you do (as the therapist to effectively intervene and attain the desired outcomes? What methods and techniques might you use?)

The situated learning theory states that the process of change is enhanced when intervention occurs in the client’s natural context or environment. It is helpful to use the tools the client uses on a daily basis, and to work in the same place the child is expected to participate in his/her occupation. Based on this theoretical assumption, to effectively intervene, we will conduct our group in the students’ classroom environment and use the materials that are familiar to the children within their classroom. There is an OT room on the second floor of the school, but conducting our group in this area would be less contextual for the clients and it would not provide the best environment for skill generalization.

Piaget’s theory informs the means through which we hope the children will achieve higher social participation outcomes. We know that the main occupation of young children is play and that it provides a way for children to experience their environment, experiment with skill refinement, and interact in a way that is nonthreatening and natural for them. Therefore, our interventions will be rooted within the context of collaborative play. As group leaders, we will structure activities that encourage the children to interact with one another, model appropriate social interactions, provide scaffolding and support to the children through verbal prompts, and consider how we organize the materials and tools that the children will need for an activity so that they need to interact with each other and negotiate sharing materials. Not only is play the means for our intervention, it will also be the ends because the children will hopefully be motivated during our group games and have fun playing together as they use skills that will strengthen friendships with their peers.

Social Learning Theory: Social learning theory uses the techniques of modeling, reinforcement, and scaffolding, to teach individuals new skills. Modeling is the idea that people can learn by observing behaviors of others and the outcomes of those behaviors. Models may be live, symbolic, or verbal. So if we as leaders model to the children the proper ways to interact with one another, hopefully they will understand and copy our actions. When the behavior is modeled correctly, reinforcement should be given to encourage more of the same behavior. Contrastingly, when an incorrect behavior is modeled, the consequence of that behavior should also be observed so that the learner fully understands why that behavior is inappropriate.

According to Vgotsky’s idea of the zone of proximal development, there is always a gap between what someone can do alone and what he/she can do with assistance. Therefore through the use of scaffolding, more difficult tasks can be accomplished in collaboration with a more competent person or a more skilled partner. This technique can also be applicable within our group because each of the boys in the class are currently at different level developmentally. Some are better at asking questions, while other are better at sharing toys and play space. We should be able to use this to our advantage when dividing the group up for various activities and offering assistance.


d.
Principles for measuring outcomes: (What outcomes will you measure to demonstrate that the group has been effective? How and how often will you measure the projected outcomes? Whose perspective will be considered (i.e. client, staff, and/or group leaders)? Describe how the measure will be used. If you are planning to use a formal standardized assessment, please identify assessment. If you area planning to use a customized measure, please include a sample of the measure.

Specific outcomes that we will measure weekly will be the use of good manners (saying “please” and “thank you”), turn taking/sharing, and engaging in coversation with peers (e.g. asking a peer a question, and responding to questions appropriately). We believe that through using these social skills, the children will improve their social interactions and develop friendships with their classmates. We are fortunate to have 3 teachers, aside from the group leaders, present during our session. We will ask each teacher, who will be assigned to observe one child) to document how often he uses one of the skills mentioned above.

Overall, we will also be gathering information about how the teacher perceives the child’s overall social interaction at the beginning of intervention, compared to the end of intervention. She will fill out an adapted questionnaire from the SFA (social domains only) for each child and the students’ change over time will be evaluated to determine the effectiveness of intervention. We are hoping this information will not only help us measure the student’s progress from another perspective, but also give us some insight into how the skills may be generalizing to the rest of the classroom

One problem we will have with measuring outcomes in this group however, is that the focus of the entire afternoon program is on social skills. So on the days we are not there, the teachers are working on many of the same basic goals. Therefore, if progress is observed there is no way of knowing whether it is a direct result of our group, or the entire program in general.

e.
Principles for generalization: (What strategies will you use to promote sustainability of group outcomes and/or facilitate generalization of outcomes to desired contexts?)

To promote the generalization of skills, we will use the following strategies:
Orchestrate peer involvement (e.g., prompting & initiating social interactions, physical proximity)
Use multiple group leaders & individuals with which to practice skills
Provide opportunities to practice skills in safe, natural settings (e.g., classroom)
Use time between session to practice skills (e.g., via ‘homework’) Teachers will be asked to place a sticker on the body cut-outs that the students make in the first week if they observe them using good body awareness skills during play.


3. If you have identified several theoretical perspectives describe how they will work together to guide the group intervention.

From a social learning perspective, the activities that the students engage in during group will provide opportunities for role-play, observations of peers and adult models, problem solving, and real-life practice of social skills through structured games; all components of Bandura’s (1997) theory. The learning of the students will be reinforced by the environment and the cognitive processes they engage in during intervention. As the students gain more and more practice incorporating social skills in play, their self-efficacy will increase as they know that they can be successful in interacting with others in a way that will promote friendships. All of these ideas are set within the backdrop of a natural environment that is familiar to the clients and one of the real-world places they are expected to use social skills, e.g. the classroom. Building upon this situated learning theory, all of the interventions are also within the natural context of play, the primary occupation of preschool children. As the students engage in play, the environment will influence how they think about their peer interactions and shape their learning and behavior.